Indoor Tanning dangers
Melanoma incidence has climbed steeply in the U.S., doubling between 1982 and 2011. The rise in melanoma is projected to continue.1 One contributor to these rising rates of melanoma is the use of tanning beds and other indoor tanning devices by young people, especially young women. Young women use indoor tanning most frequently, especially those in their late teens and twenties. About 20 percent of female high school students and young women 18-25 engage in indoor tanning.2-4 Indoor tanning in young people is especially alarming, since indoor tanning before the age of 30 incre
ases melanoma risk by 75 percent. Melanoma is the type of skin cancer responsible for the most deaths .5 In 2009, the International Agency for Research on Cancer of the World Health Organization classified UV tanning devices as carcinogenic to humans.5
In an analysis of 31 studies, using indoor tanning at least once was associated with a 16 percent increase in melanoma risk, and more than 10 sessions with a 22 percent increase in risk. Indoor tanning is also associated with elevated risk of other skin cancers—squamous cell carcinoma (67 percent) and basal cell carcinoma (29 percent).6 Tanning devices also increase the risk of ocular (eye) melanoma.5
It is important to understand that ultraviolet radiation can promote cancer even if sunburn does not occur. Even among people who have never had sunburn, those who use indoor tanning are much more likely to be diagnosed with melanoma.7 Though commonly associated with a “healthy glow,” it is important to keep in mind that tanning of the skin is not healthy; in fact, tanning occurs after skin damage has already occurred, as the body’s attempt to prevent sunburn with further sun exposure. Tanning is the body’s response to DNA damage in skin cells from UV exposure, DNA damage which is also a trigger for skin cancer development.8,9
Compared to sunbathing, UV radiation from indoor tanning is more intense. Tanning devices emit both UVA and UVB radiation, but primarily UVA; both types contribute to skin cancer. Tanning devices my emit UVA doses 10-15 times higher than the UVA emitted by midday sunlight, giving indoor tanning the potential to be much more risky than sunbathing.10
Giving up indoor tanning is difficult for many people who tan frequently, possibly because they have developed a dependence. UV-induced DNA damage, in addition to causing tanning, also increases the expression of beta-endorphin, a substance which has a positive effect on mood, leading to reinforcing effects of indoor tanning device use.8,11 One small study giving opiate-receptor blocking drug to frequent tanners reported they experienced withdrawal symptoms, implying addiction-like effects.9,12
Using sun protection when you spend time outdoors and avoiding indoor tanning devices are the primary means of preventing melanoma and other skin cancers. Also remember that carotenoid-rich foods, such as leafy greens, orange vegetables and tomatoes help the skin to combat the DNA damage from UV light.
1. Guy GP, Jr., Thomas CC, Thompson T, et al: Vital signs: melanoma incidence and mortality trends and projections - United States, 1982-2030. MMWR Morb Mortal Wkly Rep 2015;64:591-596.
2. Guy GP, Jr., Berkowitz Z, Tai E, et al: Indoor tanning among high school students in the United States, 2009 and 2011.JAMA Dermatol 2014;150:501-511.
3. Centers for Disease C, Prevention: Use of indoor tanning devices by adults--United States, 2010. MMWR Morb Mortal Wkly Rep 2012;61:323-326.
4. Colantonio S, Bracken MB, Beecker J: The association of indoor tanning and melanoma in adults: systematic review and meta-analysis. J Am Acad Dermatol 2014;70:847-857 e841-818.
5. Sunbeds and UV Radiation. International Agency for Research on Cancer, World Health Organization; 2009.
6. Wehner MR, Shive ML, Chren MM, et al: Indoor tanning and non-melanoma skin cancer: systematic review and meta-analysis. BMJ 2012;345:e5909.
7. Vogel RI, Ahmed RL, Nelson HH, et al: Exposure to indoor tanning without burning and melanoma risk by sunburn history. J Natl Cancer Inst 2014;106.
8. Tran TT, Schulman J, Fisher DE: UV and pigmentation: molecular mechanisms and social controversies. Pigment Cell Melanoma Res 2008;21:509-516.
9. Fisher DE, James WD: Indoor tanning--science, behavior, and policy. N Engl J Med 2010;363:901-903.
10. Balk SJ, Fisher DE, Geller AC: Teens and indoor tanning: a cancer prevention opportunity for pediatricians. Pediatrics2013;131:772-785.
11. Tejeda HA, Bonci A: Shedding "UV" light on endogenous opioid dependence. Cell 2014;157:1500-1501.
12. Kaur M, Liguori A, Lang W, et al: Induction of withdrawal-like symptoms in a small randomized, controlled trial of opioid blockade in frequent tanners. J Am Acad Dermatol 2006;54:709-711.